Decreases in Opioid Prescribing by State Varied After CDC Guidance

After the US Centers for Disease Control and Prevention (CDC) released its 2016 CDC Guideline for Prescribing Opioids for Chronic Pain, previously existing reductions in dispensing accelerated broadly, although the magnitude of varied by state. Researchers reported their findings online in JAMA Network Open.

“There is previous evidence that, while dispensing rates were already decreasing, the release of the 2016 CDC Guideline corresponded to an acceleration of those decreasing trends, and our results largely corroborate those findings,” wrote corresponding author Jason Goldstick, PhD, of the University of Michigan in Ann Arbor, Michigan, and study coauthors.

This cross-sectional study investigated state-level trends in monthly opioid dispensing trajectories between 2012 and 2018. Researchers looked at four areas: opioid dispensing per 100,000 persons, long-acting opioid dispensing per 100,000 persons, high-dose dispensing per 100,000 persons, and average per capita morphine milligram equivalents (MME).

After the 2016 release of the prescribing guideline, the already decreasing slope accelerated nationally for all four measures, according to the study. While the vast majority of states showed comparable acceleration of decreasing slopes, state-to-state heterogeneity was substantial.

“Slope changes (preguideline − postguideline slope) ranged from 9.15 (Massachusetts) to 74.75 (Mississippi) for overall dispensing, 1.88 (Rhode Island) to 13.41 (Maine) for long-acting dispensing, 0.71 (District of Columbia) to 13.68 (Maine) for high-dose dispensing, and 0.06 (Hawaii) to 0.91 (Arkansas) for per capita MME,” researchers reported.

Understanding state-level trends and variations in opioid prescribing may help inform future efforts to improve prescribing and reduce related harm, researchers advised.

Reference

Lyu X, Guy GP, Baldwin GT, Losby JL, Bohnert ASB, Goldstick JE. State-to-state variation in opioid dispensing changes following the release of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. JAMA Netw Open. 2023;6(9):e2332507. doi:10.1001/jamanetworkopen.2023.32507